Provider Demographics
NPI:1447306774
Name:FEARNOW, DANIEL S (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:FEARNOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8485 US HIGHWAY 64
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4102
Mailing Address - Country:US
Mailing Address - Phone:901-377-3001
Mailing Address - Fax:901-377-3130
Practice Address - Street 1:8485 US HIGHWAY 64
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-4102
Practice Address - Country:US
Practice Address - Phone:901-377-3001
Practice Address - Fax:901-377-3130
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2009-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD 013220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3188185Medicaid
TN3188185Medicare PIN
TNBO4322Medicare UPIN